Inter-regional trends in causes of childhood blindness and low vision in Ghana.
blindness
childhood
low vision
visual impairment
Journal
Clinical & experimental optometry
ISSN: 1444-0938
Titre abrégé: Clin Exp Optom
Pays: United States
ID NLM: 8703442
Informations de publication
Date de publication:
09 2020
09 2020
Historique:
received:
14
12
2018
revised:
13
11
2019
accepted:
01
12
2019
pubmed:
10
1
2020
medline:
4
8
2021
entrez:
10
1
2020
Statut:
ppublish
Résumé
Inter-regional trends of visual loss in most developing countries remain largely unknown. We compared the causes of childhood blindness among children attending blind schools in the northern (one school) and southern (two schools) regions of Ghana and assessed their need for spectacles and low-vision devices. Using a standardised methodology, children were examined by an ophthalmologist and optometrists in each location. Causes of visual loss were classified anatomically and by time of onset, and avoidable causes identified. Children identified with functional low vision were assessed and provided with low-vision devices. A total of 252 children under 16 years of age were examined in the schools. The overall prevalence of total blindness was 73 (29.0 per cent), with similar proportions (p = 0.87) in the north (29 [28.4 per cent]) and south (44 [29.3 per cent]); 92 (36.5 per cent) had functional low vision. Two children improved with spectacles and 35 benefited from low-vision devices. Corneal scarring was significantly (p = 0.045) more prevalent in southern Ghana (n = 150) than in the north (n = 102), responsible for visual loss in 36 (24.0 per cent, 95% CI 17.2-30.8 per cent) and 14 (13.7 per cent, 95% CI 7.0-20.4 per cent) cases, respectively. No significant difference (p = 0.321) was observed in the prevalence of cataract between northern (28: 27.5 per cent, 95% CI 18.3-36.2 per cent) and southern Ghana (33: 22.0 per cent, 95% CI 15.4-28.6 per cent). Over 87 per cent of children had 'avoidable' causes of visual loss, with a higher proportion being treatable (124: 49.2 per cent) than preventable (96: 38 per cent). Cataract was the major cause of visual loss in the overall population. The south had a higher proportion of corneal scarring and late-onset blindness compared with the north. More than one-third of blindness in blind schools in Ghana could have been prevented by primary care interventions and nearly half could have been treated surgically to prevent visual loss. Two in five children in blind schools in Ghana could benefit from optical intervention.
Sections du résumé
BACKGROUND
Inter-regional trends of visual loss in most developing countries remain largely unknown. We compared the causes of childhood blindness among children attending blind schools in the northern (one school) and southern (two schools) regions of Ghana and assessed their need for spectacles and low-vision devices.
METHODS
Using a standardised methodology, children were examined by an ophthalmologist and optometrists in each location. Causes of visual loss were classified anatomically and by time of onset, and avoidable causes identified. Children identified with functional low vision were assessed and provided with low-vision devices.
RESULTS
A total of 252 children under 16 years of age were examined in the schools. The overall prevalence of total blindness was 73 (29.0 per cent), with similar proportions (p = 0.87) in the north (29 [28.4 per cent]) and south (44 [29.3 per cent]); 92 (36.5 per cent) had functional low vision. Two children improved with spectacles and 35 benefited from low-vision devices. Corneal scarring was significantly (p = 0.045) more prevalent in southern Ghana (n = 150) than in the north (n = 102), responsible for visual loss in 36 (24.0 per cent, 95% CI 17.2-30.8 per cent) and 14 (13.7 per cent, 95% CI 7.0-20.4 per cent) cases, respectively. No significant difference (p = 0.321) was observed in the prevalence of cataract between northern (28: 27.5 per cent, 95% CI 18.3-36.2 per cent) and southern Ghana (33: 22.0 per cent, 95% CI 15.4-28.6 per cent). Over 87 per cent of children had 'avoidable' causes of visual loss, with a higher proportion being treatable (124: 49.2 per cent) than preventable (96: 38 per cent).
CONCLUSION
Cataract was the major cause of visual loss in the overall population. The south had a higher proportion of corneal scarring and late-onset blindness compared with the north. More than one-third of blindness in blind schools in Ghana could have been prevented by primary care interventions and nearly half could have been treated surgically to prevent visual loss. Two in five children in blind schools in Ghana could benefit from optical intervention.
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
684-692Informations de copyright
© 2020 Optometry Australia.
Références
World Health Organization. Programme for Prevention of Blindness; Management of Low Vision in Children. 1992. [Cited 20 Jan 2018.] Available at: http://whqlibdoc.who.int/hq/1993/WHO_PBL_93.27.pdf
World Health Organization. WHO/PBL Examination Record for Children with Blindness and Low Vision. 2005. [Cited 12 Dec 2018.] Available at: https://www.cehjournal.org/resources/who-childhood-blindnesssoftware
Gilbert C, Foster A. Childhood blindness in the context of VISION 2020 - the right to sight. Bull World Heal Organ 2001; 79: 227-232.
Chandma A, Gilbert C. When your eye patient is a child. Community Eye Health 2010; 23: 1-3.
Sola-Carmona JJ, Lopez-Liria R, Padilla-Gongora D et al. Subjective psychological well-being in families with blind children: how can we improve it? Front Psychol 2016; 7: 1-8.
Rainey L, Elsman EBM, van Nispen RMA et al. Comprehending the impact of low vision on the lives of children and adolescents: a qualitative approach. Qual Life Res 2016; 25: 2633-2643.
Ntim-Amponsah CT, Amoaku WMK. Causes of childhood visual impairment and unmet low-vision care in blind school students in Ghana. Int Ophthalmol 2008; 28: 317-323.
Debrah O, Mensah EO, Senyonjo L et al. Elimination of trachoma as a public health problem in Ghana: providing evidence through a pre-validation survey. PLoS Negl Trop Dis 2017; 11: 1-15.
Akafo SK, Hagan M. Causes of childhood blindness in Southern Ghana: a blind school survey. Ghana Med J 1990; 24: 113-119.
Huh GJ, Simon J, Prakalapakorn SG. Causes of childhood blindness in Ghana: results from a blind school survey in Upper West Region, Ghana, and review of the literature. Int Ophthalmol 2018; 38: 1415-1423.
Ghana Statistical Service. Poverty Trends in Ghana; 2005-2017. Ghana Statistical Service. 2018. [Cited 12 Jun 2018.] Available at: http://www.statsghana.gov.gh/docfiles/publications/GLSS7/Poverty_Profile_Report_2005-2017.pdf
Ghana Statistical Service. 2010 Population and Housing census report; Mortality Ghana Statistical Service 2014. [Cited 22 Jun 2018.] Available at: https://www.statsghana.gov.gh/gssmain/fileUpload/pressrelease/Mortality%20in%20Ghana.pdf
Potter A, Debrah O, Ashun J, Blanchet K. Eye Health Systems Assessment (EHSA): Ghana Country Report. Ghana Health Service, International Centre for Eye Health, Sightsavers. 2013. [Cited 15 Jul 2018.] Available at: https://www.iapb.org/wp-content/…/Ghana-Eye-Health-System-Assessment-Report.pdf
Ebri A, Govender P. Ghana Primary Eyecare Feasibility Assessment. 2017. [Cited 11 Sep 2018.] Available at: https://d2fyyic8pcxcmc.cloudfront.net/documents/187-5908-bhvi-ghana-report.pdf
Morny EKA, Boadi-Kusi SB, Ocansey S et al. Assessing the progress towards achieving “VISION 2020: the right to sight” initiative in Ghana. J Environ Public Health 2019; 2019: 3813298.
Adu-Gyamerah E. 91 Eye doctors in Ghana 68 Work in Greater Accra alone. Graphic Publications Ltd. 2019. [Cited 21 Feb 2019.] Available at: https://www.graphic.com.gh/news/general-news/91-eye-doctors-in-ghana-68-work-in-greater-accra-alone.html
Merepa SS, Akowuah PK, Abazele AS et al. An assessment of the human resource in eye care in the upper east region, Ghana. Adv Ophthalmol Vis Syst 2017; 7: 6-9.
State University. Ghana - History Background - Education, Coast, Schools, and Gold - StateUniversity.com. [Cited 28 Oct 2018.] Available at: http://education.stateuniversity.com/pages/529/Ghana-HISTORY-BACKGROUND.html
Schwartz TL, Coakley RR, Schwartz L et al. A practical approach to low-vision rehabilitation in children. J Am Assoc Pediatr Ophthalmol Strabismus 2007; 11: 108.
Amaya L, Taylor D, Russell-Eggitt I et al. The morphology and natural history of childhood cataracts. Surv Ophthalmol 2003; 48: 125-144.
Gyasi ME. Setting the pace for VISION 2020 in Ghana: the case of Bawku. Community Eye Health 2006; 19: 46-47.
Kazungu JS, Adetifa IMO. Crude childhood vaccination coverage in West Africa: trends and predictors of completeness. Wellcome Open Res 2017; 2: 12.
Ho VH, Schwab IR. Social economic development in the prevention of global blindness. Br J Ophthalmol 2001; 85: 653-657.
Rotchford AP, Rotchford KM, Mthethwa LP et al. Reasons for poor cataract surgery uptake - a qualitative study in rural South Africa. Trop Med Int Heal 2002; 7: 288-292.
Mehari ZA, Zewedu RTH, Gulilat FB. Barriers to cataract surgical uptake in central Ethiopia. Middle East Afr J Ophthalmol 2013; 20: 229-233.
Bronsard A, Geneau R, Shirima S et al. Why are children brought late for cataract surgery? Qualitative findings from Tanzania. Ophthalmic Epidemiol 2008; 15: 383-388.
Annan GN, Asiedu Y. Predictors of neonatal deaths in ashanti region of Ghana: a cross-sectional study. Adv Public Heal 2018; 2018: 1-11.
World Health Organization. WHO | Blindness: Vision 2020 - The Global Initiative for the Elimination of Avoidable Blindness. WHO. World Health Organization. 2010. [Cited 1 Nov 2018.] Available at: http://www.who.int/mediacentre/factsheets/fs213/en/
Kansakar I, Thapa HB, Salma KC et al. Causes of vision impairment and assessment of need for low vision services for students of blind schools in Nepal. Kathmandu Univ Med J 2009; 7: 44-49.
Silver J, Gilbert CE, Spoerer P et al. Low vision in east African blind school students: need for optical low vision services. Br J Ophthalmol 1995; 79: 814-820.
World Health Organization. International Statistical Classification of Diseases and Related Health Problems. 10th revision, 5th ed., World Health Organization. 2016. [Cited 1 Nov 2018.] Available at: https://apps.who.int/iris/handle/10665/246208